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https://www.readbyqxmd.com/read/28730720/microstructural-white-matter-brain-abnormalities-in-patients-with-idiopathic-fecal-incontinence
#1
J Muthulingam, S Haas, T M Hansen, S Laurberg, L Lundby, H S Jørgensen, A M Drewes, K Krogh, J B Frøkjaer
BACKGROUND: Abnormal central nervous system processing of visceral sensation may be a part of the pathogenesis behind idiopathic fecal incontinence (IFI). Our aim was to characterize brain differences in patients with IFI and healthy controls by means of structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). METHODS: In 21 female patients with IFI and 15 female healthy controls, whole-brain structural differences in gray matter volume (GMV), cortical thickness, and white matter tracts fractional anisotropy (FA) were quantified...
July 21, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28729224/robotic-placement-of-fenix-continence-restoration-system-in-a-patient-with-previous-radiation-to-the-pelvis-a-case-report
#2
Mariana Espinal, Christopher C DeStephano, Paulami Guha, Shilpa P Gajarawala, Anita H Chen, Paul D Pettit
Fecal incontinence (FI) is a disabling problem affecting women. Conservative treatment includes dietary modification, antimotility agents, and pelvic floor physical therapy. If conservative medical management is unsuccessful, surgical intervention may be required. Surgical options include rectal sphincteroplasty, bulking agent injection, radiofrequency anal sphincter remodeling procedure and sacral nerve stimulation (SNS) therapy. Recently, a new therapy for FI, the FENIX Continence Restoration System has become available...
July 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28728991/analysis-of-factors-associated-with-patient-or-caretaker-regret-following-surgery-for-fecal-incontinence
#3
Bhalaajee Meenakshi-Sundaram, Caitlin T Coco, James R Furr, Byron P Dubow, Christopher E Aston, Jennifer Lewis, Gennady Slobodov, Bradley P Kropp, Dominic C Frimberger
PURPOSE: The Malone Antegrade Continence Enema (MACE) has been a successful and widely used procedure to achieve fecal continence in children. We present data on the previously uninvestigated issue of patient and caretaker regret following surgery for intractable constipation and fecal incontinence. MATERIALS AND METHODS: We reviewed all patients undergoing antegrade continence enema or cecostomy creation at a single institution between 2006 and 2016. Patients and caretakers were assessed for decisional regret utilizing the Decisional Regret Scale...
July 17, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28727646/development-and-validation-of-a-quantitative-measure-of-adaptive-behaviors-in-women-with-pelvic-floor-disorders
#4
John T Wei, Rodney Dunn, Ingrid Nygaard, Kathryn Burgio, Emily S Lukacz, Alayne Markland, Patricia A Wren, Linda Brubaker, Matthew D Barber, J Eric Jelovsek, Cathie Spino, Susie Meikle, Nancy Janz
PURPOSE: To establish validity for the Pelvic Floor Disorders Network (PFDN) self-administered Adaptive Behavior Index (ABI) and to assess whether ABI assesses known discordance between severity of pelvic floor symptoms and self-reported bother. METHODS: In addition to the ABI questionnaire, participants in 1 of 6 Pelvic Floor Disorders Network trials completed condition-specific measures of pretreatment symptom severity (including Pelvic Floor Distress Inventory; PFDI) and health-related quality of life (Pelvic Floor Impact Questionnaire; PFIQ)...
July 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28727645/retroperitoneal-hemorrhage-after-sacral-neurostimulator-placement-for-urgency-urinary-incontinence
#5
Casey L Kinman, Deslyn T G Hobson, Anubhav Agrawal, Martin S Vyleta, Sean L Francis
Sacral neuromodulation (SNM) is an effective therapy for patients who experience urinary incontinence, idiopathic urinary retention, and fecal incontinence. Although typically a low-risk procedure, rarely, it can be associated with significant hemorrhage. A 61-year-old woman on chronic anticoagulation underwent uncomplicated implantation of SNM for refractory urgency urinary incontinence. Anticoagulation was held on the day of surgery and resumed on postoperative day 1. On postoperative day 2, the patient developed an extensive retroperitoneal hemorrhage...
July 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28723864/sacral-neuromodulation-for-fecal-incontinence-a-review-of-the-central-mechanisms-of-action
#6
Paul T J Janssen, Niels Komen, Jarno Melenhorst, Nicole D Bouvy, Ali Jahanshahi, Yasin Temel, Stephanie O Breukink
OBJECTIVE: Fecal incontinence (FI) has a devastating effect on the quality of life and results in social isolation. Sacral neuromodulation (SNM) is proven to be an effective, minimal invasive treatment modality for FI. Despite the increasing application of SNM, the exact mechanisms of action remain unclear. The initial assumption of peripheral motor neurostimulation is not supported by increasing evidence, which report effects of SNM outside the pelvic floor. A new hypothesis states that afferent signals to the brain are essential for a successful therapy...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28719236/applying-an-artificial-neural-network-model-for-developing-a-severity-score-for-patients-with-hereditary-amyloid-polyneuropathy
#7
Shenia Novis, Felipe Machado, Victor B Costa, Debora Foguel, Marcia W Cruz, José Manoel de Seixas
Hereditary (familial) amyloid polyneuropathy (FAP) is a systemic disease that includes a sensorimotor polyneuropathy related to transthyretin (TTR) mutations. So far, a scale designed to classify the severity of this disease has not yet been validated. This work proposes the implementation of an artificial neural network (ANN) in order to develop a severity scale for monitoring the disease progression in FAP patients. In order to achieve this goal, relevant symptoms and laboratory findings were collected from 98 Brazilian patients included in THAOS - the Transthyretin Amyloidosis Outcomes Survey...
July 18, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/28718924/preliminary-study-of-a-novel-puborectalis-like-artificial-anal-sphincter
#8
Wentian Jin, Guozheng Yan, Hao Wu, Shan Lu, Zerun Zhou
Artificial anal sphincter (AAS) is an in situ implanted device that acts as a treatment for fecal incontinence regardless of etiology by augmenting the incompetent sphincteric structures. However, AAS is impeded from becoming a valid therapy by its high rate of ischemic complication and malfunction. This article presents an original puborectalis-like artificial anal sphincter (PAAS) that features a low risk of ischemia necrosis and rectal perception remodeling. The device retains continence by reproducing the action, including the pulling and angulating the rectum, of the puborectalis muscle, which forms the anorectal angle and reduces the required clamping pressure...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28717406/neurogenic-bowel-dysfunction-in-patients-with-neurogenic-bladder
#9
Laura Martinez, Leila Neshatian, Rose Khavari
Patients with primary neurologic conditions often experience urinary and bowel dysfunction due to loss of sensory and/or motor control. Neurogenic bowel dysfunction is frequently characterized by both constipation and fecal incontinence. In general, the management of neurogenic bowel dysfunction has been less well studied than bladder dysfunction despite their close association.. It is widely accepted that establishment of a multifaceted bowel regimen is the cornerstone of conservative management. Continuing assessment is necessary to determine need for more invasive interventions...
December 2016: Current Bladder Dysfunction Reports
https://www.readbyqxmd.com/read/28712050/spatiotemporal-expression-of-bcl-2-bax-and-neural-cell-apoptosis-in-the-developing-lumbosacral-spinal-cord-of-rat-fetuses-with-anorectal-malformations
#10
Zhonghua Yang, Yuanyuan Geng, Zhiya Yao, Huimin Jia, Yuzuo Bai, Weilin Wang
Fecal incontinence and constipation still remain the major complications after procedures for anorectal malformations (ARMs). Previous studies have demonstrated a decrease of neural cell in lumbosacral spinal cord of ARMs patients and rat models. However, the underlying mechanism remains elusive. In this study, the neural cell apoptosis and Bcl-2/Bax expression were explored during lumbosacral spinal cord development in normal and ARMs fetuses. ARMs rat fetuses were induced by treating pregnant rats with ethylenethiourea on embryonic day 10...
July 15, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28706405/vulvar-lichen-sclerosus-et-atrophicus
#11
REVIEW
Pragya Ashok Nair
Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful...
April 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#12
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28705367/dynamic-magnetic-resonance-imaging-of-the-pelvic-floor
#13
Sindhura Alapati, Kedar Jambhekar
Pelvic floor dysfunction is a widespread condition affecting up to 50% of elderly women. It markedly compromises the quality of life owing to various disabling symptoms such as pelvic pain, pelvic organ prolapse, and urinary and fecal incontinence. Although age and female sex are the main risk factors, others include multiparity, obesity, and connective tissue disorders. Pelvic floor dysfunction is frequently multicompartmental, and failure to diagnose it accurately often leads to treatment failure. Dynamic pelvic floor magnetic resonance imaging is a robust tool that enables simultaneous visualization of the 3 pelvic floor compartments and is indispensable for precise preoperative evaluation...
June 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28705292/a-case-of-ischemia-induced-perianal-ulceration-mimicking-pyoderma-gangrenosum
#14
Michael Joseph Lavery, Nicola Cooke
A 68-year-old woman, with a 75-pack-year smoking history and a history of chronic excess alcohol intake, presented with a 5-week history of worsening perianal pain and ulceration. She recently had an inpatient admission with back pain and urinary tract infection during which she developed diarrhea and fecal incontinence. Initially, the perianal ulceration was diagnosed as severe irritant contact dermatitis and treated with barrier creams and topical clobetasone 17-butyrate 0.05% weight for weight, oxytetracycline 3...
2017: Skinmed
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#15
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28699286/clinical-anatomy-of-fecal-incontinence-in-women
#16
REVIEW
Priyanka K Kadam-Halani, Lily A Arya, Uduak U Andy
Fecal incontinence is a devastating condition that has a severe impact on quality of life. This condition disproportionately affects women and its incidence is increasing with the aging United States population. Fecal continence is maintained by coordination of a functioning anal sphincter complex, intact sensation of the anorectum, rectal compliance, and the ability to consciously control defecation. Particularly important are the puborectalis sling of the levator ani muscle complex and intact innervation of the central and peripheral nervous systems...
July 12, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28695312/use-of-biological-mesh-in-trans-anal-treatment-for-recurrent-recto-urethral-fistula
#17
G Moretto, A Casaril, M Inama
PURPOSE: To report the author's experience on a mini-invasive technique using bioprosthetic plug and a rectal wall flap advancement in the treatment of recurrent recto-urethral fistula. MATERIALS AND METHODS: Between 2013 and 2015, seven patients with recurrent recto-urethral fistula were referred to the Pederzoli Hospital, Peschiera del Garda, Verona, Italy. Intraoperatively all patients were found to have a rectal wall lesion and were treated with urinary and fecal diversion...
July 10, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28689239/structure-function-relationship-of-the-human-external-anal-sphincter
#18
Amanda M Stewart, Mark S Cook, Keisha Y Dyer, Marianna Alperin
INTRODUCTION AND HYPOTHESIS: Obstetrical external anal sphincter (EAS) injury and subsequent dysfunction are leading risk factors for female fecal incontinence (FI). Limited knowledge of the EAS structure-function relationship hinders treatment optimization. We directly measured functionally relevant intrinsic parameters of human EAS and tested whether vaginal delivery alters the EAS structure-function relationship. METHODS: Major predictors of in vivo EAS function were compared between specimens procured from vaginally nulliparous (VN, n = 5) and vaginally parous (VP, n = 7) cadaveric donors: operational sarcomere length (Ls), which dictates force-length relationship; physiological cross-sectional area (PCSA), which determines isometric force-generating capacity; fiber length (Lfn), responsible for muscle excursion and contractile velocity; and muscle stiffness...
July 8, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#19
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
Incontinence-inducing delivery injuries, such as obstetric fistula and anal-sphincter tears, are devastating sequelae of prolonged and obstructed labor, and can only be repaired through surgery. Such injuries are most prevalent in settings where delays and limitations in accessing emergency obstetric services are common [1, 2]. The 2011 Demographic and Health Survey of Uganda [3] estimated that 2% of Ugandan women have experienced obstetric fistula and resulting trans-vaginal urine or fecal incontinence. This article is protected by copyright...
July 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28682972/temperature-controlled-delivery-of-radiofrequency-energy-in-fecal-incontinence-a-randomized-sham-controlled-clinical-trial
#20
Arjan P Visscher, Tze J Lam, Maria M Meurs-Szojda, Richelle J F Felt-Bersma
BACKGROUND: Controlled delivery of radiofrequency energy has been suggested as treatment for fecal incontinence. OBJECTIVE: The aim of this study was to determine whether the clinical response to the radiofrequency energy procedure is superior to sham in patients with fecal incontinence. DESIGN: This was a randomized sham-controlled clinical trial from 2008 to 2015. SETTING: This study was conducted in an outpatient clinic...
August 2017: Diseases of the Colon and Rectum
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